SITSA Act

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, I thank Mr. Marino, and I want to make it very clear that we have spent a lot of time in the Judiciary Committee, in this Congress, in the Energy and Commerce Committee, on almost every other bill in stemming the tide, the rage, the horror of opioid addiction.

Mr. Chairman, I have lived through crack cocaine addiction and heroin addiction, and now heroin has returned, itself. I have watched my constituents in these low-drug offenses wind up not getting treatment and wind up getting the devastation of mass incarceration.

Frankly, if this bill had listed the synthetic analogues on schedule A and provided the science to determine what they were, this would be a bill that the whole House could support, but that is not the case.

And so I raise concerns that I hope this House will listen to and recognize that opportunities to fix this legislation as we move to the Senate would make this the kind of response that has been consistent with the view that the incarceration of an opioid-addicted person and/ or those who are limited sellers does not bring us to where we need to be.

Mr. Chair, I rise to discuss the Stop the Importation and Trafficking of Synthetic Analogues Act of 2017, which establishes a mechanism by which synthetic drugs can be temporarily and permanently controlled to curtail illicit manufacturing, importation, and distribution. H.R. 2851 would also establish new Federal crimes related to the misuse of controlled substances identified in the bill.

I am acutely concerned about the dangers presented by drugs like fentanyl and its synthetic analogues that have contributed to a disturbing number of overdose deaths, even in my home district of Houston.

This bill, while well-intended, is flawed for several reasons. First, it eliminates the use of scientific evidence by which synthetic analogues are currently analyzed.

Under current law, the Attorney General must work in collaboration with drugs experts at the Department of Health and Human Services as part of the permanent scheduling process. Absent collaboration of the scientific community, the AG, under this bill, will have sole discretion to unilaterally determine which drugs are a schedule A substance.

This is alarming because arbitrary scheduling of substances without verifiable data will undoubtedly create disproportionate incarcerations of low-level drug offenders.

Second, this bill overcriminalizes drug offenders, many of whom are in dire need of support in their battles with addiction, substance abuse, and mental illness. We recognize this is an alarming epidemic and the need for medical treatment is very important.

Third, although we know that synthetic analogues are often manufactured and mixed with heroin outside the country--namely, China-- and where users and sellers here may lack knowledge, this bill heightens the penalties, nonetheless.

In June 2016, the head of the DEA, Chuck Rosenberg, testified before the Senate Judiciary Committee that: ``Illicit fentanyl, fentanyl derivatives and their immediate precursors are often produced in China.'' By the time the drugs enter the United States, where they are sold, he said, buyers and sellers are often unaware of the composition and potency of the drugs.

Fourth, this bill amends the Federal sentencing guidelines without the input of the United States Sentencing Commission, which recently underwent a robust examination of synthetic drugs and penalties.

The bill disregards the jurisdictional authority granted by Congress to the Commission back in 1984. The Commission is a nonpartisan, independent body which sets sentencing guidelines for Federal judges.

Since the introduction of this bill, the Commission approved a multipart synthetic drugs amendment in April 2018, which included extensive public comment, expert testimony, and a multiyear data analysis.

The Commission's recent amendment reflects the evolving nature of these synthetic drugs, creates a class-based approach, establishes a new drug ratio and a new guideline penalty for fentanyl analogues that will promote uniformity in Federal sentencing. We should, therefore, allow this more thorough and data-driven process to come to completion, absent interruption by the Attorney General, as provided in the bill.

And lastly, this bill imposes mandatory minimum terms of supervised release of not less than 3 years in addition to imprisonment, and not less than 6 years if there was a prior conviction.

Furthermore, the bill also appears to impose mandatory minimum sentencing. Current law requires that if a controlled substance analogue is intended for human consumption, it shall be treated as a schedule I substance, 21

U.S.C. 813. Because the analogue would be treated as a schedule I drug, the penalty of such drugs is not less than 20 years mandatory minimum if death or serious bodily injury occurs.

Under 21 U.S.C. 802(32) a controlled substance analogue is:

A substance (i) the chemical structure of which is

substantially similar to the chemical structure of a

controlled substance in schedule I and II;

(ii) which has a stimulant, depressant, or hallucinogenic

effect on the central nervous system.

Under this bill, a schedule A drug is a substance that has a chemical structure that is substantially similar to the chemical structure of the controlled substance in schedules I, II, III, IV, and V, an actual or predicted stimulant, depressant, or hallucinogenic effect on the central nervous system.

The penalty for such drugs under this bill is not more than 10 years, no mandatory minimum, and if serious bodily injury occurs, not more than 15.

Therefore, if the composition of a schedule A drug is substantially similar to the chemical structure of a substance in schedule I or II, then we have a mandatory minimum problem, unless the bill explicitly says in its penalty provision that a schedule I penalty is not triggered by placement of a substance in schedule A.

This creates great ambiguity with respect to sentencing because the vague language leaves an endless number of individuals exposed to mandatory minimum and, of course, mass incarceration.

Given the number of new drugs out there and the constant evolving nature of these synthetic drugs, it is unknown at this point and unfair in this bill's framework the number of drugs that will trigger a mandatory minimum sentence.

If we are committed to giving treatment, if we are committed to stopping the mass incarceration and steering people away from the use of opioid drugs, that will be the preferable approach: to take note of the fact that they are on schedule A, to provide the scientific background, and to then allow the existing sentencing structure to proceed.

Mandatory minimum sentencing for drug offenses gave birth to an explosion in our prison population. It is responsible for many of our criminal justice deficiencies. It is really the reason why we are fighting for sentencing reduction.

Congress acknowledged this as a devastating policy approach and, as a result, passed the Fair Sentencing Act. Inclusion of new mandatory minimum sentencing is particularly egregious because these inflexible one-size sentencing laws undermine justice by preventing judges from fitting the punishment to the individual and the circumstances of their offenses, like the 19-year-old seller who, as the DEA Administrator said, may not have even known that it was laced.

Mandatory sentencing laws have caused Federal prison populations to soar, destroying families and communities, and led to overcrowding and exorbitant costs to taxpayers.

And so I ask my colleagues, let us work together to work on the bill before us and focus it on ways that get to the dastardliness of synthetic analogues but, as well, responds mercifully to the increasing incarceration of persons through mandatory minimums and the lack of using the United States Sentencing Commission's guidelines.

Mr. Chair. H.R. 2851, ``Stop the Importation and Trafficking of Synthetic Analogues Act of 2017,'' establishes a mechanism by which synthetic drugs can be temporarily and permanently controlled to curtail illicit manufacturing, importation and distribution.

H.R. 2851 would also establish new federal crimes related to the misuse of controlled substances identified in the bill.

I am acutely concerned about the dangers presented by drugs like fentanyl and its synthetic analogues that have contributed to a disturbing number of overdose deaths, even in my home district of Houston.

This bill while well-intended, is flawed for several reasons: First, it eliminates the use of scientific evidence by which synthetic analogues are currently analyzed.

Under current law, the Attorney General must work in collaboration with drug experts at the Department of Health and Human Services (HHS) as part of the permanent scheduling process.

Absent collaboration of the scientific community, the AG, under this bill, would have sole discretion, to unilaterally determine which drugs are Schedule A substance.

This is alarming because arbitrary scheduling of substances without verifiable data, will undoubtedly create disproportionate incarceration of low-level drug offenders.

Second, this bill over criminalizes drug offenders, many of whom are in dire need of support in their battles with addiction, substance abuse and mental illness.

We recognize this as an alarming epidemic, and the need for medical treatment, which is why we appropriated an exuberant amount of money towards the opioid crisis in our recent omnibus bill which passed in the House.

Third, although we know that synthetic analogues are often manufactured and mixed with heroin outside the country, namely China, and where users and sellers here may lack knowledge, this bill heightens the penalties nonetheless.

In June 2016, the head of the DEA Chuck Rosenberg testified before the Senate Judiciary Committee that, ``Illicit fentanyl, fentanyl derivatives, and their immediate precursors are often produced in China.''

By the time the drugs enter the United States, where they are sold, he said, buyers and sellers are often unaware of the composition and potency of the drugs.

Fourth, this bill amends the federal sentencing guidelines without the input of the U.S. Sentencing Commission (Commission), which recently underwent a robust examination of synthetic drugs and penalties.

The bill disregards the jurisdictional authority granted by Congress to the Commission back in 1984.

The Commission is a non-partisan, independent body, which sets sentencing guidelines for federal judges.

Since the introduction of this bill, the Commission approved a multi- part synthetic drugs amendment in April 2018, which included extensive public comment, expert testimony and a multi-year, data analysis.

The Commission's recent amendment reflects the evolving nature of these new synthetic drugs, creates a class-based approach, establishes new drug ratios and a new guideline penalty for fentanyl analogues that will promote uniformity in federal sentencing.

We should therefore, allow this more thorough and data-driven process to come to completion, absent interruption by the Attorney General as provided in this bill.

And lastly, this bill imposes mandatory minimum terms of supervised release of not less than 3 years in addition to imprisonment, and not less than 6 years if there was a prior conviction.

Furthermore, the bill also appears to impose mandatory minimum sentencing.

Current law requires that if a controlled substance analogue is intended for human consumption, it shall be treated as a schedule I substance. (21 USC 813).

Because the analogue would be treated as a schedule I drug, the penalty for such drugs is not less than 20 years (mandatory minimum) if death or serious bodily injury occurs.

Under 21 USC 802(32), a ``controlled substance analogue'' is: A substance (i) the chemical structure of which is substantially similar to the chemical structure of a controlled substance in schedule I or II; (ii) Which has a stimulant, depressant, or hallucinogenic effect on the central nervous system. . . .

Under this bill, a Schedule A drug is a substance that has a Chemical structure that is substantially similar to the chemical structure of a controlled substance in schedule I, II, III, IV or V; and

An actual or predicted stimulant, depressant, or hallucinogenic effect on the central nervous system. . . .

The penalty for such drugs under this bill is not more than 10 years (no mandatory minimum), and if serious bodily injury occur, not more than 15 years.

Therefore, if the composition of a schedule A drug is substantially similar to the chemical structure of a substance in schedule I or II, then we have a mandatory minimum problem, unless the bill explicitly says in its penalty provision, that a schedule I penalty is not triggered by placement of a substance on schedule A.

This creates great ambiguity with respect to sentencing, because the vague language leaves endless number of individuals exposed to mandatory minimum sentencing.

Given the number of new drugs out there, and the constant evolving nature of these synthetic drugs, it is unknown at this point and under this bill's framework, the number of drugs that will trigger a mandatory minimum sentence.

Mandatory minimum sentencing for drug offenses gave birth to the explosion in our prison population, and is responsible for many of our criminal justice system's deficiencies. Thus, we cannot return there again.

Congress acknowledged this as a devastating policy approach, and as a result, passed of the Fair Sentencing Act.

Inclusion of a new mandatory minimum sentence, is particularly egregious because these inflexible, one-size sentencing laws undermine

justice by preventing judges from fitting the punishment to the individual and the circumstances of their offenses.

Mandatory sentencing laws have caused federal prison populations to soar, destroyed families and communities, and led to overcrowding and exorbitant costs to taxpayers.

I reserve the balance of my time.

Mr. Chairman, I yield 3\1/2\ minutes to the gentleman from Virginia (Mr. Scott), who is the ranking member of the Education and the Workforce Committee.

Mr. Chairman, I yield 2 minutes to the gentleman from Illinois (Mr. Schneider). Congressman Bradley Scott Schneider is a member of the House Judiciary Committee.

Mr. Chairman, I yield 5 minutes to the distinguished gentleman from New Jersey (Mr. Pallone), who is the ranking member of the Energy and Commerce Committee.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, does the gentleman have further speakers?

Mr. Chairman, I yield myself the balance of my time.

We all want to do good, and all of us have had our tragedies as it relates to the use of drugs by the innocent. As I listened to my colleagues, they are right: The heinous persons are those who are the major exporters and the hardened drug dealers.

We want to save lives. I think we found over the last couple of months and past years that enhancing the research and providing treatment for those very individuals who have succumbed will provide us with that pathway.

In the instance of the underlying bill, I would hope that we would have the opportunity to get the bad guys. But in the instance of the way it is constructed, SITSA will worsen the mass incarceration of drug offenders; it will expand the use of harsh maximum sentences for drug offenses; and the bill creates new penalties for thousands of synthetic drugs, calling for maximum sentences of 10, 20, 30 years, or life imprisonment.

The carve-out for possession does not define quantities that would constitute possession and will not prevent many people who possess small quantities or sell drugs to support their own addiction from getting slammed by draconian new penalties in SITSA.

So we have addicted persons who sell on the streets of our neighborhoods. They need treatment. That is what we should be focusing on. SITSA will punish people who lack criminal culpability. This bill will disproportionately increase low-level drug offenders who did not import or package the drug and often are unaware of the chemical composition of the drugs, as the DEA Administrator indicated in his testimony before the Senate that most of the sellers would not know that there had been traces of other drugs in that particular drug they were selling.

SITSA is unnecessary because the Attorney General can already ban synthetic drugs. This was demonstrated earlier this year when the Attorney General used powers already granted by the Congress to place illicit fentanyl analogues not already regulated by the Controlled Substances Act into schedule I for 3 years, allowing time to pursue permanent scheduling.

Through rulemaking, at a congressional hearing last month, Acting Administrator Patterson indicated: This mass scheduling action addressed concern that prosecutors can't convict people for trafficking synthetic drugs.

Finally, SITSA has devastating impacts on scientific research. Many synthetic drugs share chemical properties with drugs that have been known to have therapeutic uses, such as opioids. Under SITSA, once a drug has been added to schedule A, many of the same hurdles that apply to conducting research with schedule I drugs will apply to substances added to proposed schedule A.

These burdens will be costly and time consuming. Some of them are research dealing with how do you stop this addiction, how do you stop people's proclivity for addiction. So this burden is costly and time consuming to the research and host institutions and will have a chilling effect on promising research towards the development of opioid addiction therapies and safer medications to treat pain that are desperately needed to help end the ongoing opioid overdose crisis.

While SITSA provides some relief for researchers who already have a schedule I or II, there are many difficulties that we are facing.

Mr. Chair, how much time is remaining on both sides.

Mr. Chair, while SITSA provides some relief for researchers who already have a schedule I or II registration to proceed with schedule A research, SITSA does not provide accommodations necessary to ensure researchers can obtain drug

samples for research. Commercial manufacturers are not likely to produce schedule A drugs.

Provisions in SITSA intended to ease registration requirements will help little when researchers access the drug material they need to study the therapeutic potential.

Here is the main point. The main point is that researchers are researching how to cease the addiction that is killing so many. Low- level sellers are caught up under this bill; and, as indicated by the DEA, they, too, are victims. It is well known that the idea of mass incarceration does not solve the problem of addiction or cause the ending of the tragic loss of life.

I hurt for those suffering from addiction, and it is important to be able to utilize our government knowledge to help that end, and the Sentencing Commission has done that.

The difficulty we have is whether or not this bill, even though from Judiciary, really bears down on saving lives. What we want to do is raise the treatment, deal with those already structured to handle the listing of analogues, and work with communities to ensure that the laws we have are enforced and that we don't create a whole new population of those who will be victims of mass incarceration and, at the same time, do nothing to treat those who desperately need our help, our support, and our resources to move them away from addiction, to save their lives, and to allow them to live fruitful and productive lives.

That is what I hope that we will be able to do as we move forward on the right approach to dealing with drug addiction and the new surge of synthetic drugs.

Mr. Chair, may I inquire if the gentleman from Pennsylvania has any further speakers.

Mr. Chair, I yield such time as he may consume to the gentleman from New York (Mr. Nadler), the distinguished ranking member of the Judiciary Committee.

Mr. Chair, we hope that we will be able to work together to save lives and to fix the issues that we are addressing here today.

Mr. Chair, we all want to solve the escalating problems of synthetic drugs, which permeate throughout our districts.

Therefore, our initial reaction would be to naturally support this endeavor.

However, while well-intended, this bill highlights many problems and does not fulfill the overall goal of stemming the tide of drugs on our streets.

We must exercise prudence, as to not further exacerbate the crisis of mass incarceration and punish those that need help with substance abuse and whom this bill purports to help.

Because this bill would concentrate an overwhelming amount of unchecked power within DOJ, eliminate scientific and medical analysis and interagency collaboration from the process of scheduling synthetic analogues, and expand penalties for drug offenses, I have serious concerns about H.R. 2851.

The bill is strongly opposed by a broad spectrum of stakeholders, including Freedom Works, Drug Policy Alliance, Families Against Mandatory Minimum, ACLU, The Leadership Conference on Civil and Human Rights, National Council of Churches, Human Rights Watch, The Sentencing Project and many others.

Mr. Chair, I yield back the balance of my time.

Mr. Chairman, let me just very quickly thank the gentleman from Maryland (Mr. Raskin) and Mr. Griffith. I am delighted to join them, and I will simply say it is equally essential that science has a role in this very complex process to ensure the appropriate penalties are being applied based on compositions of the synthetic drugs involved.

I congratulate both of them for the excellent work that has been done, and I am delighted to be a cosponsor of the amendment.

Mr. Chair, I rise in support of the Griffith/Raskin/Jackson Lee Amendment. The amendment will reflect the current process under existing law.

Under current law, the Attorney General must work collaboratively with the Department of Health and Human Services (HHS) and its experts in the scientific community, in order to determine best practices for the permanent scheduling process.

Given the variation in toxicity levels in many of these synthetic drugs, it is imperative that the research community be involved in the process to ensure accuracy of defining the chemical structure of these drugs or substances.

It is equally essential that science have a role in this very complex process to ensure the appropriate penalties are being applied based on compositions of the synthetic drugs involved.

At markup I made it clear that we should not proceed with this bill absent involvement from the scientific community.

Today, I am pleased to be a co-sponsor of this amendment with my colleagues Griffith and Raskin.

In addition to restoring collaboration with the research community, this amendment also provides that permanent scheduling cannot occur earlier than 3 years after the Attorney General issues a temporary scheduling order.

This allows the scientific community time to address any pending issues that pertain to the drugs temporarily scheduled and prior to placing them on schedule A permanently.

If the research finds that these temporarily scheduled drugs lack sufficient potential for abuse that would qualify such drugs under schedule A, then this amendment provides that the Attorney General has 30 days in which he must terminate the temporary scheduling order for that drug or substance.

This is a sensible amendment that will provide oversight of the scheduling process. And for these reasons, I support this amendment and urge my colleagues to support this amendment.

Mr. Chairman, I have an amendment at the desk.

Mr. Chairman, my amendment is simple. It restores the commission's jurisdiction over the

Federal sentencing guidelines as originally granted by Congress in 1984.

The United States Sentencing Commission has been working to address the seriousness and complexity of synthetic drugs for several years. If I might refer my colleagues to the April 12 meeting of the Sentencing Commission where the chairman began his remarks and indicated that the commission was going to move forward on a multipart amendment regarding synthetic drugs, which will include but be not limited to K2 or spice, fentanyl and fentanyl analogues.

This amendment draws upon public comment, expert testimony, and data analysis gathered during a multiyear study of synthetic drugs. That is what the Sentencing Commission does, and my amendment asks to remove the section in this underlying legislation that directs this responsibility to the Attorney General.

The process that was created by the Sentencing Commission created a new guideline definition of the term fentanyl analogue. The change effectively raises the guideline penalties for fentanyl analogues to a level more consistent with the current statutory penalty structure to address the severe dangerousness of fentanyl.

The amendment also creates a four-level sentencing enhancement for knowingly misrepresenting or knowingly marketing fentanyl or fentanyl analogues as another substance which equates to an approximate 50 percent increase in sentence length.

What I am saying to my colleagues is that we have a structure. The report was issued on April 2018. The Sentencing Commission has done its job, and I think that we would do well to embrace the work that has been done here. The commission's recent amendment creates a class-based approach for synthetic drugs, establishes new drug ratios, and a new guideline for fentanyl analogues, so it is unnecessary to have section 9 in the present legislation.

Mr. Chairman, I would ask my colleagues to support the Jackson Lee amendment, and I reserve the balance of my time.

Mr. Chairman, I thank the gentleman from Pennsylvania, and, as well, the chairman of the Judiciary Committee and the ranking member of the Judiciary Committee. We worked on this, and I am glad that our staff was able to communicate.

I think it is important to emphasize that, going forward, the Sentencing Commission will continue its multiyear study to ensure that the Federal sentencing guidelines are updated to reflect any new challenges resulting from these serious drugs and that they be addressed in the Federal sentencing guidelines.

Consistent with its mission established by Congress in the Sentencing Reform Act of 1984, the commission will also work to update guidelines on an annual basis to reflect any new needs that we may have with respect to these new and growing synthetic analogues and other drugs that are continually coming, tragically, into the marketplace.

Mr. Chairman, I have here a public data presentation for synthetic drugs, dated January 2018; also the April 2018 report; and, as well, the opening statement of the chairman of the Sentencing Commission dated April 12, 2018.

Mr. Chair, I rise in support of the Jackson Lee amendment, which restores the Commission's jurisdiction over the federal sentencing guidelines, as originally granted by Congress.

The United States Sentencing Commission has been working to address the seriousness and complexity of synthetic drugs for several years.

Since this legislation was introduced, the Sentencing Commission approved a multi-part synthetic drugs amendment in April 2018.

The Commission conducted extensive research of past cases and current data, held multiple hearings and engaged in extensive collaboration with DOJ, DEA and experts to determine the best manner to address these drugs within the context of the federal sentencing guidelines.

The Commission's recent amendment creates a class-based approach for synthetic drugs, establishes new drug ratios and a new guideline penalty for fentanyl analogues.

Consistent with the established process, the recent amendment reflected a deliberative, data-driven process which included extensive public comment, expert testimony and data analysis gathered during a multi-year study of synthetic drugs.

Section 9 of H.R. 2851 should be struck from the pending legislation because: It is unnecessary, overly broad and duplicative of the Commission's existing action. Section 9 will result in greater litigation and delays for the federal courts. This section would also undermine the certainty in federal sentencing for synthetic drugs that would otherwise be avoided based on the Commission's new amendment. Congress delegated the authority to amend the federal sentencing guidelines two decades ago in order to ensure fair, data-driven outcomes in federal sentencing. This provision is an unprecedented and unnecessary departure from the process that has worked well since established by Congress in 1984.

Going forward, the Commission will continue its multi-year study to ensure that the federal sentencing guidelines are updated to reflect any new challenges resulting from these serious drugs are addressed in the federal sentencing guidelines.

Consistent with its mission established by Congress in the Sentencing Reform Act of 1984, the Commission will also work to update the guidelines on an annual basis to reflect any new laws enacted by Congress.

For all these reasons, I support this amendment and ask my colleagues to do the same.

Mr. Chairman, I ask my colleagues to support the Jackson Lee amendment, and I yield back the balance of my time.

Mr. Chairman, I thank the gentleman from New York for capturing the scourge of the epidemic of online drug sales that reach into the living rooms of so many innocent persons, and my sympathy for the loss of one of our heroes who wore the uniform.

Mr. Chairman, I rise to support this amendment as contributing to the important information knowledge chain that is so necessary to families to help stop this scourge of going after innocent persons in their homes.

Mr. Chairman, I claim the time in opposition to the amendment.

Mr. Chairman, I rise in opposition to amendment No. 4 proposed by the gentleman from Texas.

The amendment adds a list of factors that may be considered when proving whether a particular substance was intended for human consumption.

I oppose this amendment for two reasons.

First, because criminal liability could result from one of the factors being proven merely under a negligent standard. Only whether the defendant should have known the substance was intended to be consumed by injection, inhaling, ingestion, or any other immediate means, it is not an appropriate standard to which we should attach criminal liability, particularly severe consequences such as mandatory minimums.

Now, I have indicated that we have an action by the U.S. Sentencing Commission that took place on April 2018. We have a detailed analysis of the range of analogues, synthetic analogues, including K2, spice, and other fentanyl analogues, but not limited to. Therefore, we have a marker. We have a standard to save lives. And what we should be emphasizing, again, is treatment.

Second, this amendment actually makes it easier to trigger mandatory minimums. For instance, a defendant could be subjected to a 20-year mandatory minimum in instances where serious bodily harm injury results. I am opposed to amendment 4 because defendants could be subjected to such mandatory minimums relying, in part, on proof that they should have known a substance was intended for human consumption.

Now, let me be very clear. Some of these individuals who are defendants are, themselves, addicted, and, therefore, they are acting as an addicted person. It is not an excuse, but it emphasizes that we should steer ourselves more toward a maximizing of treatment and education to stop the scourge of the utilization of these drugs.

That is clearly, as well, taken care of under the U.S. Sentencing Commission, meaning that these concerns of the gentleman, which I respect his concerns, are taken care of by a long list of responses and sentencing for the different drugs that are noted as synthetic analogues. Again, we do have a basis going forward. The gentleman's concerns can be taken care of in already established law and policies by the U.S. Sentencing Commission.

I have long opposed any laws that will trigger mandatory minimums because we have seen the results of that. We have also heard over time from the U.S. judicial commission, if you will, because this takes away a judge's discretion and interferes with their sound judgment in sentencing the individual defendants that appear before them. Therefore, I oppose amendment No. 4.

Mr. Chairman, I thank the Rules Committee for allowing my amendment to be placed in order. I also believe that, at this point, we would do well to follow regular order to save lives and to continue to allow the Sentencing Commission to move forward as they made their commitment in the chairman's letter. The chairman of the commission said that they will not stop working on synthetic analogues and that they will continue to structure the right kind of criminal justice that works as it relates to sentencing to ensure that the concerns of my colleague are taken.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, how much time do I have remaining?

Mr. Chair, again, let me indicate that I appreciate the gentleman's concern. I am concerned that simply a negligence standard would be the standard for judging a defendant under this particular amendment: should have known the substance was intended to be consumed by injection, inhaling, injection, or any other immediate means. That is not an appropriate standard that would attach criminal liability and particularly severe consequences such as a mandatory minimum.

Again, I am holding up one of the reports from the Sentencing Commission, and I would make the argument that it is thorough in its review, and our colleagues can be comforted by the fact that, again, the Sentencing Commission will continue its work and it will continue to address some of the concerns of my friend from Texas. I would hope that we would allow that process to proceed.

I think it would be very concerning to all of us if we had a negligence standard. I believe the courts will address the fact based upon the defendant and the facts that we have in place.

Mr. Chair, I ask my colleagues to oppose the amendment and oppose the underlying bill

Mr. Chair, I rise in opposition to Amendment 13, proposed by Mr. Thornberry. The amendment adds a list of factors that may be considered when proving whether a particular substance was intended for human consumption. I oppose this amendment for two reasons:

First, because criminal liability could result from one of the factors being proven merely under a negligence standard--only whether the defendant should have known the substance was intended to be consumed by injection, inhalation, ingestion or any other immediate means. It is not an appropriate standard

to which we should attach criminal liability, particularly, severe consequences, such as mandatory minimums.

Second, this amendment actually makes it easier to trigger mandatory minimums. For instance, a defendant could be subjected to a 20-year mandatory minimum in instances where serious bodily injury results. I am opposed to Amendment 13 because defendants could be subjected to such mandatory minimums relying in part on proof that they should have known a substance was intended for ``human consumption''.

I have long been opposed to any laws that trigger mandatory minimums because they take away judges' discretion and interfere with their sound judgment in sentencing the individual defendants that appear before them. Therefore, I oppose Amendment 13.

Mr. Chair, I yield back the balance of my time.

Mr. Chair, I demand a recorded vote.

Mr. Speaker, I demand a recorded vote.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 949 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts (Mr. McGovern), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.

General Leave

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks.

Mr. Speaker, House Resolution 949 provides for the consideration of three important bills aimed at curbing the deadly opioid epidemic plaguing this country and providing Americans with the tools to overcome their addictions: H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, or the SUPPORT Act; H.R. 5797, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act; and H.R. 6082, the Overdose Prevention and Patient Safety Act.

The three bills included in today's rule all seek to accomplish one goal: assist Americans struggling with opioid addiction in controlling their addictions and moving forward in achieving productive and healthy lives.

The rule provides for 1 hour of debate on H.R. 6, equally divided and controlled by the chair and ranking minority member of the Committee on Energy and Commerce. The rule makes in order eight amendments offered by both Republicans and Democrats. Further, the rule provides the minority with one motion to recommit with or without instructions.

The resolution also provides for a structured rule for H.R. 5797, allowing 1 hour of debate to be divided and controlled between the chair and ranking minority member of the Energy and Commerce Committee. The rule also provides for debate on an amendment by Mrs. Mimi Walters of California, an active member of the Energy and Commerce Committee. Finally, the rule provides the minority with the customary motion to recommit with or without instructions.

The final bill included in today's resolution, H.R. 6082, will also receive 1 hour of debate on the House floor, equally divided and controlled by the chair and ranking member of the Energy and Commerce Committee. As the Committee on Rules received no germane amendments to H.R. 6082, no amendments were made in order in today's rule. The minority does receive the customary motion to recommit with or without instructions.

The statistics that many of us have heard on numerous occasions--at our district townhalls, in opioid roundtables with stakeholders, constituent meetings in our offices, and in our committee hearings--are truly heartbreaking stories, with more than 115 people dying in the United States every day from an opioid overdose. That is five people per hour.

According to national reports, emergency room visits and opioid overdose deaths have more than quadrupled in the last 15 years, and a preliminary analysis indicates those numbers are to rise. The misuse of and addiction to opioids--including prescription pain medications, heroin, and synthetic opioids such as fentanyl--is, indeed, an urgent national crisis that continues to threaten our public health, social fabric, and economic welfare. Both community hospitals and local paramedics are frequently coming across people overdosing on an opioid drug or a drug laced with fentanyl.

The opioid epidemic has affected families not only in my district in north Texas, but in communities large and small from Maine to California. It has also impacted American employers and businesses due to lost productivity and difficulty finding qualified candidates for employment. President Trump is right to call this epidemic the ``crisis next door.''

The efforts of the Energy and Commerce Committee in the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act in the previous Congress were a good start, delivering critical funding and resources to communities hit most hard by the opioid epidemic. But there was much more we still could do.

To start this process, the Energy and Commerce Health Subcommittee, which I chair, held a Member Day last October, where more than 50 bipartisan Members of this body, both on and off the committee, shared their personal stories from their districts and offered their solutions. This was followed by a series of three legislative hearings with markups where nearly 60 bills were considered and advanced to the full Energy and Commerce Committee that acted on these bills shortly thereafter.

The culmination of the work from the Energy and Commerce Committee and other House committees has brought us to consider many of these policies over the course of the last 2 weeks on the House floor. It required an all-hands-on-deck approach, and I believe the American people will see that, by this week's end, we did, indeed, come together in a bipartisan fashion and worked to address this crisis.

Today's rule provides for consideration of three important bills that will expand treatment options, deliver lifesaving services, and make necessary public health reforms, including Medicare and Medicaid, to bolster prevention and recovery efforts.

First, H.R. 5797, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act, the IMD CARE Act, allows State Medicaid programs to remove the institutions for mental diseases exclusion for beneficiaries aged 21 to 64 with an opioid use disorder for 5 years' time. The bill provides the continuum of care

by removing a barrier of care under current law, so Medicaid can cover up to a total of 30 days of care in an institute for mental disease during a 12-month period, and eligible enrollees can get the care that they actually need.

The IMD exclusion is one of the treatment barriers consistently identified by State Medicaid directors, health policy experts, and many provider groups. Currently, this exclusion under Medicaid significantly limits the circumstances under which Federal Medicaid matching funds are available for inpatient services or for outpatient treatments.

Unfortunately, this policy has barred individuals with an opioid use disorder and mental illness from accessing short-term, acute care in psychiatric hospitals, or receiving treatment in residential substance use disorder treatment facilities. A 2017 Medicaid and CHIP Payment and Access Commission report stated that the Medicaid IMD exclusion is one of the few examples in the Medicaid program where Federal financial participation cannot be used for medically necessary and otherwise covered services for a specific Medicaid population receiving treatment in a specific setting.

In the midst of the opioid crisis, States must leverage all available tools to combat this epidemic. Section 1115 demonstration waivers are an important tool, but, so far, less than half of the States have sought or received an appropriate waiver from the Centers for Medicare and Medicaid Services to help patients with substance use disorder.

The IMD CARE Act also allows States the option to use the State plan amendment process, which is generally faster than using waivers. Under this process, once a State plan amendment is submitted, the Centers for Medicare and Medicaid Services has 90 days to decide or the proposed change will automatically go into effect.

H.R. 5797 amends an outdated law that has been in effect since the enactment of the Medicaid program in 1965. Since that time, there have been advances in behavioral health, and there have been advances in addiction treatment services where more, improved treatment options now exist.

It is long overdue to revisit this policy so that State Medicaid programs can better meet patients' needs and physicians can determine the most appropriate setting for care based on an individual's treatment plan.

Next, H.R. 6082, the Overdose Prevention and Patient Safety Act, makes timely reforms to a privacy law that affects patient access to healthcare and creates barriers to treatment. Specifically, the bill updates the Public Health Service Act to permit substance use disorder records to be shared among covered entities and 42 CFR part 2 programs by aligning part 2 with the Health Insurance Portability and Accountability Act of 1996 for the purposes of treatment, payment, and healthcare operations.

As a physician, I believe it is vital that when making clinical decisions, I have all of the appropriate information to make the correct determination in the treatment of a particular patient. Those suffering from substance use disorder should receive the same level of treatment and care as other individuals.

Patients afflicted with substance use disorder deserve to be treated by physicians who are armed with all of the necessary information to provide the best possible care.

I certainly do understand and respect that patient privacy protection is paramount and should be held in the highest regard.

The Overdose Prevention and Patient Safety Act maintains the original intent of the 1970s statute behind 42 CFR part 2 by protecting patients and improving care coordination. In fact, this bill increases protections for those seeking treatment by more severely penalizing those who share patient data to noncovered entities and non-part 2 programs than under the current statute, with certain exceptions.

Lastly, it requires the Secretary of Health and Human Services to, among other things, issue regulations prohibiting discrimination based on disclosed health data and requiring covered entities to provide written notice of privacy practices.

The issue of the stigma associated with substance use disorder has been a constant in many of the discussions members of the Energy and Commerce Committee and the stakeholders have had in both our offices and in our hearings.

This carefully crafted legislation seeks to help break the stigma and help individuals with this complex disease gain access to healthcare and support services critical to getting them on the road to recovery.

We should not continue to silo the substance use disorder treatment information of a select group of patients if we want to ensure that these patients are indeed receiving quality care. This information should be integrated into our medical records and comprehensive care models to prevent situations where physicians, not knowing a patient's substance use disorder, may prescribe medications that have significant drug interactions, or worse, may prescribe a controlled substance that makes their patient's substance use disorder worse.

As it currently stands, 42 CFR part 2 is actively prohibiting physicians from ensuring proper treatment and patient safety and, paradoxically, it is perpetuating that stigma.

Providing high quality healthcare is a team effort, but physicians leading the team must have the necessary information to adequately coordinate care. We must align payment, operations, and treatment to allow coordination of both behavioral and physical health services for individuals with substance use disorder.

There is a reason why the Substance Abuse and Mental Health Services Administration and most of the health stakeholder community are asking for this change. Clearly, there is an issue here that must be addressed. H.R. 6082 achieves the goal and contributes to Congress' effort in trying to stem the current crisis.

Finally, Mr. Speaker, H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, is a package of bills that reform Medicare, Medicaid, and other health provisions to further combat this crisis by advancing many critical initiatives.

As we all know, this opioid epidemic is in our hospitals, but it is also in our living rooms and on our streets. Our partners at Federal agencies must rise to the challenge and deliver vital resources for States and communities most devastated by the crisis. The SUPPORT for Patients and Communities Act will provide our Department of Health and Human Services, including the Centers for Medicare and Medicaid Services and the Food and Drug Administration, with the necessary tools to address this crisis.

Title I of H.R. 6 addresses the ways in which Medicaid can be used to increase access to quality care and management for individuals suffering from substance use disorders. Some of these changes in Medicaid reflect the success of our State Medicaid programs by implementing State successes at the Federal level.

Section 101 under title I will expand protection for at-risk youth by requiring State Medicaid programs to restore Medicaid coverage of a juvenile following their release from incarceration. The next section also allows former foster youth to maintain their Medicaid coverage across State lines until they turn 26 years of age. These are vulnerable populations of individuals that will greatly benefit from increased access to treatment.

Section 105 builds on the current State Medicaid drug utilization review, which saves money and promotes patient safety. This section will require State Medicaid programs to have safety edits in place for opioid refills, monitor concurrent prescribing of opioids and certain other drugs, and monitor antipsychotic prescribing for children.

Care for mothers suffering from substance use disorder and their babies who are born with neonatal abstinence syndrome is a growing problem in the face of this epidemic. Section 106 requires HHS to improve care for these infants with neonatal abstinence syndrome and their mothers. It also requires that the General Accountability Office study the gaps in Medicaid coverage for pregnant and postpartum women with substance use disorders.

Section 107 of the bill provides additional incentives for Medicaid health homes for patients with substance use disorder.

Mr. Speaker, these health homes will allow States to create a comprehensive person-centered system of care coordination for primary care, acute and behavioral healthcare, including mental health and substance use. As our healthcare system moves towards caring for the whole person, it is important that we enable our physicians and our payers to provide that comprehensive care.

The SUPPORT for Patients and Communities Act also enables better pain management for our Nation's Medicare beneficiaries, ranging from increased access to substance use disorder treatment, including through the use of telehealth, to modification of physician payment for certain nonopioid treatments in Ambulatory Surgery Centers.

Title II of the bill contains Medicare provisions that encourage the use of nonopioid analgesics where appropriate and also aims to decrease fraud and abuse regarding prescriptions by requiring e-prescribing for the coverage of Medicare Part D controlled substances.

H.R. 6 strives to provide support for at-risk beneficiaries who might fall victim to substance use disorder. Section 206 of the bill accelerates the development and the use of drug management programs for at-risk beneficiaries. While this program is currently voluntary, by plan year 2021, it will become a mandatory program.

Lastly, the bill expands Medicare coverage to include opioid treatment programs for the purpose of providing medication-assisted treatment. Opioid treatment programs are not currently Medicare providers, which forces Medicare beneficiaries who need medication- assisted treatment to pay out-of-pocket costs for those services. These efforts should provide improved access to treatment for Medicare beneficiaries who have substance use disorders while also incentivizing the use of opioid alternatives, which hopefully will prevent the development of substance use disorders.

Even though an estimated 46,000 Americans died from opioid overdoses from October 2016 to October 2017, there is a lack of innovation and a lack of investment in the development of nonaddictive pain and addiction treatment.

A bill that I introduced, H.R. 5806, the 21st Century Tools for Pain and Addiction Treatments, is included in section 301 on H.R. 6 and requires the Food and Drug Administration to hold at least one public meeting to address the challenges and the barriers of developing nonaddictive medical products intended to treat pain or addiction.

The Food and Drug Administration is also required to issue or update existing guidance documents to help address challenges to developing nonaddictive medical products to treat pain or addiction.

Mr. Speaker, I did work closely with the Food and Drug Administration to get the policy in this section correct and to ensure that it will clarify those pathways for products that, in fact, are so desperately needed by America's patients.

I have remaining concerns about the language in section 303 that will allow nonphysician providers to prescribe buprenorphine. While I understand and greatly appreciate the intent to increase access to medication-assisted treatment, as a physician, I also respect how complicated the treatment of patients suffering from substance use disorder may be.

The Hippocratic Oath, we all know, is to first, do no harm. Patient safety should be our highest priority.

This is a complex patient population, Mr. Speaker. On average, people with substance use disorder die 20 years sooner than other Americans.

Additionally, buprenorphine is a schedule III drug that can be misused and could exacerbate the underlying problem. I am unsure about expanding these authorities to additional nonphysician providers at the risk of making the problem worse. I have worked to strengthen the reporting requirements of this section of H.R. 6 and look forward to reviewing that report on this particular policy.

Taken together, H.R. 6, the SUPPORT for Patients and Communities Act, will improve access to care for individuals suffering from substance use disorder, provide our healthcare system with tools and resources that it needs to care for patients, and to help prevent future misuse of opioids.

Before I close, I would like to share a quote from President Trump. He said: ``Together, we will face this challenge as a national family with conviction, with unity, and with a commitment to love and support our neighbors in times of dire need. Working together, we will defeat this opioid epidemic.''

The number of bills and policies advanced on the House floor in the last 2 weeks illustrates our shared commitment, and I am confident that we will make significant progress in defeating this epidemic.

Mr. Speaker, I urge my colleagues to support today's rule and the three underlying bills that are critical to our Nation's effort to stem the opioid crisis.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Pennsylvania (Mr. Costello), a fellow member on the Committee of Energy and Commerce.

I yield the gentleman from Pennsylvania an additional 1 minute.

Mr. Speaker, I yield myself 1 minute.

I do want to remind everyone that 18 months ago, in the previous Congress, with the passage of the 21st Century Cures Act and the Comprehensive Addiction Recovery Act, CARA, $1 billion was made available for treating people with substance use disorder. That was then supplemented with the passage of the more recent appropriations bill last month--2 months ago, with $4 billion.

Unprecedented amounts of money have been made available in the last 18 months to combat this crisis.

And then, finally, it is very, very difficult to integrate care if you don't reform the 42 CFR part 2, which is before us today.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself 2 minutes.

Mr. Speaker, the good news is that all forms of medication-assisted treatment are required for 5 years under H.R. 6. So I look forward to the gentleman's support when we get to the vote, and I reserve the balance of my time.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, I don't need to remind anyone that the lie of the year for 2012 was: If you like your doctor, you can keep your doctor--words that will ring through this body probably for the rest of time.

I want to read from the Statement of Administration Policy, back to the business at hand, the rule on the three bills that we are considering today. This is the Statement of Administration Policy: ``Addressing the opioid crisis has been a top priority of the President since day one, and the administration welcomes legislation that complements its efforts to end the opioid crisis. The administration strongly supports House passage of bipartisan bills to protect patients enrolled in Medicare and Medicaid, create targeted programs for at-risk populations, expand access to medication-assisted treatment for opioid use disorders, and provide resources for States and communities struggling to deal with the scale of the opioid crisis.''

The statement goes on, and it concludes: ``These initiatives represent bold, evidence-based steps to prevent and treat opioid abuse, and will help save the lives of countless Americans. The administration commends the House on taking up these important bills. . . . The administration supports House passage of H.R. 5797, H.R. 6082, and H.R. 6. . . .''

Mr. Speaker, today's rule provides for the consideration of these three important pieces of legislation aimed at

addressing the opioid crisis affecting so many of our fellow Americans.

H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act; H.R. 5797, the Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act; and H.R. 6082, the Overdose Prevention and Patient Safety Act, will all play a critical role in treating patients and providing Americans the tools to put the pieces of their lives back together again.

I commend Chairman Walden for his efforts on bringing so many Members of this body into the discussion and taking the many ideas offered by Members, incorporating them into the legislative products. The result of those efforts is a legislative trio that this entire body can be proud of, and this entire body can support.

I, therefore, urge my colleagues to support today's rule and the three underlying pieces of legislation.

The text of the material previously referred to by Mr. McGovern is as follows:

An Amendment to H. Res. 949 Offered by Mr. McGovern

At the end of the resolution, add the following new

sections:

Sec. 5. Immediately upon adoption of this resolution the

Speaker shall, pursuant to clause 2(b) of rule XVIII, declare

the House resolved into the Committee of the Whole House on

the state of the Union for consideration of the bill (H.R.

4501) to increase funding for the State response to the

opioid misuse crisis and to provide funding for research on

addiction and pain related to the substance misuse crisis.

The first reading of the bill shall be dispensed with. All

points of order against consideration of the bill are waived.

General debate shall be confined to the bill and shall not

exceed one hour equally divided and controlled by the chair

and ranking minority member of the Committee on Energy and

Commerce. After general debate the bill shall be considered

for amendment under the five-minute rule. All points of order

against provisions in the bill are waived. At the conclusion

of consideration of the bill for amendment the Committee

shall rise and report the bill to the House with such

amendments as may have been adopted. The previous question

shall be considered as ordered on the bill and amendments

thereto to final passage without intervening motion except

one motion to recommit with or without instructions. If the

Committee of the Whole rises and reports that it has come to

no resolution on the bill, then on the next legislative day

the House shall, immediately after the third daily order of

business under clause 1 of rule XIV, resolve into the

Committee of the Whole for further consideration of the bill.

Sec. 6. Clause 1(c) of rule XIX shall not apply to the

consideration of H.R. 4501.

The Vote on the Previous Question: What It Really Means

This vote, the vote on whether to order the previous

question on a special rule, is not merely a procedural vote.

A vote against ordering the previous question is a vote

against the Republican majority agenda and a vote to allow

the Democratic minority to offer an alternative plan. It is a

vote about what the House should be debating.

Mr. Clarence Cannon's Precedents of the House of

Representatives (VI, 308-311), describes the vote on the

previous question on the rule as ``a motion to direct or

control the consideration of the subject before the House

being made by the Member in charge.'' To defeat the previous

question is to give the opposition a chance to decide the

subject before the House. Cannon cites the Speaker's ruling

of January 13, 1920, to the effect that ``the refusal of the

House to sustain the demand for the previous question passes

the control of the resolution to the opposition'' in order to

offer an amendment. On March 15, 1909, a member of the

majority party offered a rule resolution. The House defeated

the previous question and a member of the opposition rose to

a parliamentary inquiry, asking who was entitled to

recognition. Speaker Joseph G. Cannon (R-Illinois) said:

``The previous question having been refused, the gentleman

from New York, Mr. Fitzgerald, who had asked the gentleman to

yield to him for an amendment, is entitled to the first

recognition.''

The Republican majority may say ``the vote on the previous

question is simply a vote on whether to proceed to an

immediate vote on adopting the resolution . . . [and] has no

substantive legislative or policy implications whatsoever.''

But that is not what they have always said. Listen to the

Republican Leadership Manual on the Legislative Process in

the United States House of Representatives, (6th edition,

page 135). Here's how the Republicans describe the previous

question vote in their own manual: ``Although it is generally

not possible to amend the rule because the majority Member

controlling the time will not yield for the purpose of

offering an amendment, the same result may be achieved by

voting down the previous question on the rule. . . . When the

motion for the previous question is defeated, control of the

time passes to the Member who led the opposition to ordering

the previous question. That Member, because he then controls

the time, may offer an amendment to the rule, or yield for

the purpose of amendment.''

In Deschler's Procedure in the U.S. House of

Representatives, the subchapter titled ``Amending Special

Rules'' states: ``a refusal to order the previous question on

such a rule [a special rule reported from the Committee on

Rules] opens the resolution to amendment and further

debate.'' (Chapter 21, section 21.2) Section 21.3 continues:

``Upon rejection of the motion for the previous question on a

resolution reported from the Committee on Rules, control

shifts to the Member leading the opposition to the previous

question, who may offer a proper amendment or motion and who

controls the time for debate thereon.''

Clearly, the vote on the previous question on a rule does

have substantive policy implications. It is one of the only

available tools for those who oppose the Republican

majority's agenda and allows those with alternative views the

opportunity to offer an alternative plan.

Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

Mr. Speaker, I yield myself such time as I may consume.

(Mr. McGOVERN asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I thank the gentleman from Texas (Mr. Burgess) for yielding me the customary 30 minutes.

Mr. Speaker, my Republican colleagues are rushing to congratulate themselves for finally addressing opioid addiction. But, Mr. Speaker, what took them so long? This is an epidemic that fueled more drug overdoses in America in 2016 than died in the Vietnam war. In fact, opioids now kill more people every year than breast cancer. 115 Americans are dying from them every single day.

These statistics aren't new. They have been staring the Republicans in the face for months. The public has been pushing this Congress to act. Democrats have been pushing measure after measure after measure to address opioid addiction, but the majority has used their restrictive amendment process to block them from even getting a vote on the House floor.

More than a dozen amendments dealing with opioids have been blocked by the majority from even getting a debate. One of these amendments had bipartisan support, but it was blocked all the same.

This from a Republican majority that has already turned this Congress into the most closed Congress in history. Let me say that again. These guys, my Republican colleagues, have presided over the most closed Congress in history. There have already been 86 completely closed rules during the 115th Congress, and it is only June.

That number is expected to grow later this week as the majority considers their partisan immigration bills under a closed process.

Mr. Speaker, as well-intentioned as these bills may be, we aren't considering them in a vacuum. And here is the deal: We are taking them up at a time when Republicans are continuing their crusade against the Affordable Care Act, a law that has helped millions of Americans suffering from substance use disorders.

The Trump administration is refusing to defend the ACA. And get this: its Justice Department recently asked in a legal filing for the courts to invalidate this law's protections for preexisting conditions.

Mr. Speaker, does the majority realize that substance use disorders are a preexisting condition?

If Republicans are successful, they will make the opioid crisis even worse. And it doesn't stop there. Some conservative groups are pushing the majority to try repealing the ACA completely again before the summer is out.

This, after Republicans came within a few votes of taking healthcare from 23 million Americans last year, including those suffering from opioid addiction.

These rightwing groups released their latest repeal plan yesterday, so the words from my Republican friends today ring particularly hollow.

Mr. Speaker, we all know that the best answer to an epidemic is to get as many people as possible into treatment and to provide them and their families the support that they need. And one of the most effective ways to accomplish

this is to expand Medicaid and expand treatment options for substance abuse through the ACA.

Last October, the Republicans made clear what they think of the hundreds of thousands of Americans suffering from opioid addiction and alcohol and drug abuse. They passed a budget that makes $1.3 trillion in cuts to healthcare, including a 30 percent cut to Medicaid.

Mr. Speaker, Republicans can't bemoan the opioid epidemic on one hand and vote time and time again to cut the very healthcare systems required to treat addiction.

Nor can you set up a biased, tiered system that grants access to treatment for opioid addiction at the expense of providing treatment for addiction and abuse of other substances, like key provisions in H.R. 5797. Not only is that inhumane and immoral, but it is also ineffective. It undermines the entire health system of treating substance abuse.

Mr. Speaker, many Democrats have joined the majority in supporting one of these bills, H.R. 6, the SUPPORT for Patients and Communities Act. It is a good bill. It would help Medicare and Medicaid better respond to substance use disorders. We are working with the majority here.

So, Mr. Speaker, why won't they work with us to defend the ACA, preserve protections for preexisting conditions, and expand Medicaid.

Now, I know asking Congressional Republicans to show some empathy right now is a tall order. This is the group that has furthered President Trump's spin on family separations at the border, a policy he can change unilaterally, right now if he wanted to. I mean, children are being ripped out of their parents' arms in tears and kept in cages, warehouses, and tent cities. It is appalling and it is un-American.

You don't have to take my word for it. Republicans, like First Lady Laura Bush and Senator John McCain, have spoken out against it. And a U.S. attorney in Texas made clear it was President Trump's policy choice alone. And get this: This is a U.S. attorney who the President himself appointed.

But change is possible. Congressional Republicans can see the error of their ways. They can reject these calls for repeal. They can stop sitting idly by as President Trump attacks the Affordable Care Act. And they can start standing up for the 133 million Americans with preexisting conditions. That includes those suffering from addiction.

They could stop giving the President cover when he falsely claims that Democrats caused the chaos at the border that he clearly caused.

Stop playing with people's lives. We are talking about their healthcare. We are talking about getting treatment for addiction. For God's sake, we are talking about taking children out of the arms of their mothers. This isn't a handful of cases, it is thousands of cases. It is outrageous.

It is time for the adults in Congress, men and women of conscience, to stand up for what is right, not only on the opioid crisis, but on so many other important issues facing this country. I hope the majority comes to its senses before it is too late.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Just let me remind my colleagues again, because I think it is worth emphasizing, that no matter what we do in the next couple of days with these bills that are going to be before the House, they are rendered meaningless if the Republicans continue in their effort to cut Medicaid and to take away protections for people with preexisting conditions.

Substance use disorder is a preexisting condition and Republicans, working with the White House, are trying to eliminate that protection for people. I don't get it. It doesn't make sense. But we ought to make sure that we keep this debate in context and people know what is going on out there.

Mr. Speaker, I yield 6 minutes to the gentlewoman from California (Ms. Matsui).

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, again, none of what we are doing here today is going to matter if the Republicans and the Trump administration are successful in cutting Medicaid and in basically removing the guarantee that people who have preexisting conditions cannot be denied insurance.

I mean, if the Trump administration is successful, individuals with preexisting conditions all across the country, including individuals suffering from opioid use disorders, both in the individual and in the employer market, could face a denial of coverage or skyrocketing premiums beyond anything anybody could afford.

I don't get it. I don't understand the hypocrisy here. I know that the efforts here today are well intentioned and people are trying to do the right thing, but then you ruin it all when you gut the funding sources that help people deal with the treatment they need.

This has to stop.

I know some of my friends have ideological blinders on when it comes to anything that was passed during the Obama administration, but we have got to put the American people first, and this is a crisis that affects every single community in this country. If this administration is successful in what they are trying to do to undercut the ACA, then countless people will not have access to healthcare and will not have access to the treatment they need.

Mr. Speaker, our Nation is in the midst of a devastating opioid crisis that is spiraling out of control. Every day, more than 115 people in the United States die after overdosing on opioids, according to the National Institute on Drug Abuse. The Centers for Disease Control and Prevention has also found that opioids are responsible for 6 out of 10 overdose deaths in the United States.

The American people are in desperate need of strong action by Congress to stem the tide of the opioid scourge. We need serious public investment to quell this exploding crisis, not just legislation on the peripherals. We must direct resources to the States and local communities on the front lines of this devastating public health crisis where assistance is needed the most.

Mr. Speaker, I am going to ask my colleagues to defeat the previous question, and if we do, I will offer an amendment to bring up Representative Loebsack's legislation, H.R. 4501, the Combating the Opioid Epidemic Act. This bill would provide badly needed funding for State grants for the prevention, detection, surveillance, and treatment of opioid abuse.

Mr. Speaker, I ask unanimous consent to insert the text of my amendment in the Record, along with extraneous material, immediately prior to the vote on the previous question.

Mr. Speaker, I yield 3 minutes to the gentleman from California (Mr. Ruiz).

Mr. Speaker, I yield an additional 2 minutes to the gentleman from California.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, today, we are on the floor discussing the opioid crisis. This is an epidemic that is plaguing every community in the country, and it is killing 115 people every single day. It is heartbreaking, and, quite frankly, I am ashamed it is taking Congress so long to act.

I would again point out that anything we do in the next few days and anything we have done gets erased if the Republicans succeed in cutting Medicaid and if the President succeeds in basically eliminating protections for people with preexisting conditions.

But, Mr. Speaker, I think it is also important that people know there is a lot of stuff going on this week, and we are also awaiting word from the House Republicans when the Rules Committee will have an emergency meeting, I guess today, on two immigration bills that were posted after 9 p.m. last night.

These bills were drafted without any Democratic input, and from what we can tell, they are dangerous and they are certainly not a comprehensive solution to immigration reform. They harm children, and they leave many Dreamers behind.

This is not what our constituents want us to do. They want the President to do what he could easily do and stop separating children from their parents.

The President says that he wants Democrats to come to the table, but we never get invited to anything. I tried to go and see the President yesterday when the Republicans were meeting with him, but I was not allowed to go into the room.

I tried to shout at the President as he was walking by, but he was quickly escorted by. I wanted to show him the pictures on the border of these young children who are being taken away from their parents.

The President continues to spread mistruths about immigration and practically every other issue that is before this Congress and before this Nation, and it seems just to be getting worse.

There are such things as facts. There are such things as truth.

Yesterday, The Washington Post published an article, entitled: ``President Trump Seems to be Saying More and More Things That Aren't True.'' Well, I would like to take a few minutes to read this article, because these aren't my words, Mr. Speaker. They are the words of The Washington Post, specifically, Ashley Parker, who wrote the piece.

If the President is watching, I think it is helpful for me to read because I know he doesn't read, so maybe he can hear this.

``He's done it on Twitter. He's done it in the White House driveway. And he's done it in a speech to a business group.

``President Trump, a man already known for trafficking in mistruths and even outright lies--has been outdoing himself with falsehoods in recent days, repeating and amplifying bogus claims on several of the most pressing controversies facing his Presidency.

``Since Saturday, Trump has tweeted false or misleading information at least seven times on the topic of immigration and at least six times on a Justice Department inspector general report into the FBI's handling of its investigation into Hillary Clinton's private email server. That is more than a

dozen obfuscations on just two central topics--a figure that does not include falsehoods on other issues, whether in tweets or public remarks.

``The false claims come as the President--emboldened by fewer disciplinarians inside the West Wing--indulges in frequent Twitter screeds. A Washington Post analysis found that in June, Trump has been tweeting at the fastest rate of his Presidency so far, an average of 11.3 messages per day.

``Inside the White House, aides and advisers say they believe the media is unwilling to give Trump a fair shot and is knee-jerk ready to accuse him of lying, even in cases where the facts support his point.

``The President often seeks to paint a self-serving and self- affirming alternate reality for himself and his supporters. Disparaging the `fake news' media, Trump offers his own filter through which to view the world--offering a competing reality on issues including relationships forged (or broken) at the Group of Seven summit in Canada, the success of the Singapore summit with the North Koreans, and his administration's `zero tolerance' policy on illegal immigration.

`` `It's extraordinary how he is completely indifferent to the truth. There's just no relationship between his statements--anything he utters--and the actual truth of the matter,' said Thomas Murray, president emeritus of the Hastings Center, the founding institution in the field of bioethics. `As far as I can tell, the best way to understand anything he says is what will best serve his interests in the moment. It's irrespective to any version of the truth.'

``According to an analysis by The Post's Fact Checker through the end of May, Trump has made 3,251 false or misleading claims in 497 days, an average of 6.5 such claims per day of his Presidency.''

``And within the past week, Trump seems to have ramped up both the volume and the intensity of his false statements on two of the most prominent topics currently facing his administration: the hardline immigration policy that has led to the separation of thousands of children from their parents--which Trump erroneously blames on others-- and the 500-page inspector general report that he claims, incorrectly, exonerates him in special counsel Robert S. Mueller III's probe of Russian interference in the 2016 election.

``Bella DePaulo, a psychology researcher at the University of California Santa Barbara, said Trump's use of repetition is a particularly effective technique for convincing his supporters of the veracity of his false claims, in part because most people have a `truth bias' or an initial inclination to accept what others say as true.

`` `When liars repeat the same lie over and over again, they can get even more of an advantage, at least among those who want to believe them or are not all that motivated either way,' DePaulo said in an email. `So when people hear the same lies over and over again-- especially when they want to believe those lies--a kind of new reality can be created. What they've heard starts to seem like it is just obvious, and not something that needs to be questioned.'

``On immigration, Trump and many top administration officials have said that existing U.S. laws and court rulings have given them no choice but to separate families trying to cross illegally into the United States. But it is the administration's decision, announced in April, to prosecute all southern border crossings that has led to the separation of families.

``That hasn't stopped the President from blaming Democrats for his administration's decisions. `Democrats are the problem,' Trump wrote in one tweet. In another, he was even more blunt: `The Democrats are forcing the breakup of families at the border with their horrible and cruel legislative agenda. . . .' ''

Mr. Speaker, let me divert a little bit here. The truth is that the President caused this crisis, and it is not just me saying it and The Washington Post saying it. Listen to what some of the Republicans have said, Lindsey Graham said: ``President Trump could stop this policy with a phone call. I'll go tell him: If you don't like families being separated, you can tell DHS, `Stop doing it.' ''

Senator John McCain: ``The administration's current family separation policy is an affront to the decency of the American people, and contrary to principles and values upon which our Nation was founded. The administration has the power to rescind this policy. It should do so now.''

Senator Susan Collins, former First Lady Laura Bush--and I can go on and on and on--a whole bunch of Republicans now are all agreeing with us that the President is not telling us the truth.

So let me go back to the article: ``While Congress could pass a legislative fix, Republicans control both the House and the Senate-- making it disingenuous at best to finger the opposing party, as the President has repeatedly done.

``Speaking to the National Federation of Independent Business on Tuesday, Trump again falsely painted the humanitarian crisis as a binary choice. `We can either release all illegal immigrant families and minors who show up at the border from Central America, or we can arrest the adults for the Federal crime of illegal entry,' he said. `Those are the only two options.'

``On Twitter, the President twice in the past 4 days has singled out Germany as facing an increase in crime. `Crime in Germany is up 10 percent-plus (officials do not want to report these crimes) since migrants were accepted,' Trump wrote. `Others countries are even worse. Be smart, America.' ''

That is his tweet.

``In fact, the opposite is true. Reported crime in Germany was actually down by 10 percent last year and, according to German Interior Minister . . . the country's reported crime rate last year was actually at its lowest point in three decades.

``The President has also falsely claimed that the inspector general report `exonerated' him from Mueller's probe, when the report did not delve into the Russia investigation. When he made this argument Friday during an impromptu press gaggle in the White House driveway, a reporter pressed him on the falsehood.

`` `Sir, that has nothing to do with collusion,' the reporter said. `Why are you lying about it, sir?' ''

The bottom line, Mr. Speaker, is, we have a President who has a problem with the truth, and Congress needs to stand up and do the right thing. We need to speak the truth; we need to embrace the truth; and we need to solve some of the issues that are before the American people.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I rise for the purpose of inquiring of the majority leader the schedule for the week to come.

I yield to the gentleman from California (Mr. McCarthy), the majority leader.

(Mr. McCARTHY asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I thank my friend for the information he has given us, and I certainly thank him for his comments at the close of his initial statement on the colloquy.

We are all ecstatic, as I am sure the gentleman can understand, that after 44 years--and I might say I was an initial season ticket holder to the Washington Capitals, who started their career at the Capital Center in Prince George's County under the ownership and tutelage of Abe Pollin, an extraordinary member of our community who died, and then now under Ted Leonsis' leadership, and, of course, Alex Ovechkin's extraordinary accomplishments of his own, being named the most valuable player.

And I might say, as I know the gentleman would join me in saying, the Las Vegas team had an extraordinary accomplishment themselves, being the first expansion team ever to make it to the finals in the National Championship.

So, it was a wonderful night for those of us who live in the Washington National Capital area, and we thank the gentleman for his observation.

Let me say as well, that we share the gentleman's happiness that the economy is doing well. It is doing well. What he did not observe, but we are happy about, is that President Obama, under his leadership, took this economy from the worst economy that the gentleman and I have experienced in our lifetimes to one of the best.

Now, it was not the best, because the best economy was under Bill Clinton in the late 1990s in terms of almost every indication. But it is certainly positive information, as the gentleman has pointed out, of where the economy is now.

So we all welcome that. We are hopeful, of course, that we will build on that.

The gentleman mentions there are over 6 million jobs available. One of the challenges, as the gentleman knows, is that we don't have the skill sets matching the jobs, and that is why they are vacant. That is why they are unable to fill them. We need to, I think, focus on that. We need to focus on investing in our infrastructure.

But as was mentioned on the floor yesterday in terms of a couple of the bills Tim Ryan, in particular, mentioned, there are still 4 in 10 adults who can't pay a $400 bill if it came present. So we have work to do, and hopefully we can do that together.

But it certainly is good news that unemployment is down and the economy is moving along, continuing in the path that, from our perspective, was set by President Obama, and that President Trump, unlike President Obama, inherited a thriving, robust, growing economy. So I am pleased that we have gone to that place.

Now, I know the gentleman indicated that a number of opioid-related bills will be on the floor next week. I talked to the chairman of the committee yesterday, the gentleman from Oregon, and most of those are bipartisan bills. I hope all of them will end up, as they come to the floor, as bipartisan bills.

The addiction crisis, of course, requires that we invest in a comprehensive, long-term approach to expanding access to substance abuse treatment. I hope we can tackle this issue in a meaningful and bipartisan way. But I do want to address a number of other upcoming items for this work period, starting with the farm bill.

As the gentleman knows, last month, the farm bill failed on the House floor, and we have until June 22 to reconsider. My question is: Does the gentleman expect that we will see a farm bill on the floor by June 22?

I yield to my friend.

Mr. Speaker, I thank the gentleman for his observation.

He talks about work. We are requiring those to work to work in order to get government benefits. What is controversial about that?

Democrats support work. We want to see people working. We oppose, however, your SNAP proposal because it is antiwork. You are taking a work requirement that is working and replacing it with one that won't work.

This is not about putting people to work. It is about pretending that you care about work as cover for taking assistance away from struggling families.

As a result of this bill, there will be fewer working--I know the majority leader wants to hear this particular piece of information.

As a result of this bill as it is currently written, there will be fewer working SNAP beneficiaries, not more, and millions more people going hungry. That is the working poor who are getting nutritional assistance for themselves and their families. There will be less of them under your bill.

I yield to my friend.

Mr. Speaker, the gentleman is ecstatic about recent statistics. I think that he has, of course, warrant to be.

Let me read to the gentleman statistics over a 68-year period where Democrats have had the Presidency and Republicans have had the Presidency on and off. The gentleman's words are almost exactly the same words I heard in 2001 and 2003 when we were told and the country was told, if we adopted those tax bills that the gentleman is so very proud of--which is plunging our country $1.8 trillion into additional debt, which he and his party wrung their hands about so repeatedly--and that the CBO says is a result of what I believe to be the most fiscally irresponsible Congress in which I have served.

Let me repeat that. I have served in 18 Congresses. I believe this past Congress to be, this Congress that we are in, the most fiscally irresponsible Congress in which I have served.

Yes, we have a philosophical difference. You gave 83 percent of your tax revenues to the richest people in America. CBO says that; I don't say that. And 17 percent to all the rest; i.e., some 300 million-plus Americans.

Yes, we have a philosophical difference. We would have suggested that the mix be a little fairer to those in the middle and the bottom of the economic growth. But, no, you chose to give your benefits to the wealthiest in America. Not surprising. It is trickle-down economics one more time.

In 2001 and 2003, what happened? You did the tax cuts.

And what happened 6 years later? The country was plunged into the deepest recession you, Mr. Majority Leader, or me have ever experienced in our life. As a matter of fact, you have to be over 90 years of age to have experienced a deeper recession than was brought on by the Bush economic policies in the last decade, a depth of recession which the Obama policies brought us out of faster than any other nation in the world.

Those are the statistics. Faster than any other nation. The stock market--we are all about the stock market. The stock market went up almost 300 percent under Barack Obama. Now, when you get to 300 percent, we will about how well you have done. We will see what your trade policies that the President is imposing on the country do to employers and to employees and to consumers. We will see.

But let me tell you what has happened over the last 68 years under Democratic Presidents and under Republican Presidents. The gentleman wants to know about history. Under Republican Presidents over the 36 years that your party enjoyed control of the Presidency, the GDP grew by an average of 2.5 percent. Under Democrats for 32 years, by 4.1 percent.

Now, what did that 1.6 percent difference mean?

What it meant was, under Republican Presidents over the last 68 years, 35 million jobs were created. The gentleman talks about jobs. Under Democratic Presidents--4 less years, 32 years--there were 64.960 million jobs created.

Now, I hope, unlike your past performance, that the job growth continues, that the stock market increase continues, but that has not been the history. We will see.

So I hope that when you deal with the farm bill, notwithstanding your statistics, that you bring a bipartisan bill. Very frankly, the farm bill has historically been a farm bill. But what you did was passed a tax bill giving the rich 83 percent of its benefits. And in the farm bill you were taking nutritional assistance away from families and children. That is why you couldn't pass it, among other reasons. It was not bipartisan, as it was two Congresses ago when we reauthorized this. You tried to cut the SNAP program by $40 billion.

The gentleman well knows the Senate is not pursuing your policies either

on the Republican side or the Democratic side.

You are missing a lot of good information.

The fact of the matter is, you know your farm bill is not going to pass the Senate.

Mr. Leader, on the farm bill I would urge you to come together with us. I don't know that there is a more bipartisan member of this Congress than Collin Peterson, the ranking Democratic on the Agriculture Committee. Very frankly, the chairman was not interested in a bipartisan bill. I don't know whether it was by direction or his own view.

But let us come to a bipartisan agreement on this farm bill and pass it over to the Senate so that you can do something, not just talk about how you are reducing nutritional assistance to people that rely on it for their food every day.

Mr. Speaker, I yield to my friend.

Mr. Speaker, I hear the words of the majority leader. He and his party, without exception, opposed President Obama's programs. Without exception.

We became the majority in 2007, and we worked with President Bush on a number of things, including a very substantiation environmental bill signed by President Bush, and other bills as well.

He mentions about the rescission package. Mr. Speaker, if you will recall, when we had this debate some weeks ago, he said everything in this rescission bill is what we don't need.

Guess what, Mr. Speaker? Ebola money was rescinded in that bill some weeks ago, but not in this bill. He changed it because, very frankly, Mr. Speaker, they found out, oops, we need the Ebola money. So they took it out of this bill.

We think you need the CHIP money. We think we need the CHIP money to make sure that if there is a happening or an occurrence that occurs, the CHIP money is needed either directly or indirectly to make sure that children, in fact, are taken care of.

Who has said that? Mr. Tom Cole has said that. We have used that money effectively and appropriately.

So, Mr. Speaker, it is hard to believe that if the Ebola money--which I was assured was not needed--that cut was restored by our Republican friends, Mr. Speaker, because they found out, yes, it is needed.

Now, in terms of wasting time, 65 votes over the last Congress to repeal the Affordable Care Act--65--with a full and unquestioned knowledge that none of those votes would result in something happening for our country in the United States Senate. They weren't going to vote for that. They knew that. So we spent a lot of time on that.

Let me also say: The gentleman says let's get about our business. Let me ask the gentleman: Does he expect a bill on the DACA protectees, the Dreamers, to come on the floor next week?

Mr. Speaker, I yield to my friend.

Mr. Speaker, I thank the gentleman. I would only say, I appreciate his comments. But, Mr. Speaker, I have heard them a long time, many, many times: We are going to solve this issue.

Mr. Ryan came to the floor and said: We are going to solve this issue. You vote for this caps bill, and we will get an immigration bill on the floor that will solve this issue.

That was some 2\1/2\ months ago. It is not solved yet, Mr. Speaker. I hope the

leader does, in fact, bring a bill to the floor quickly.

In fact, the suggestion that had been made by many Members of his party and mine to bring four options to the floor seems absolutely consistent with the Speaker's pledge to take the tough issues head-on; and that is, bring the Democratic bill that is cosponsored by one of the senior Republicans, Ileana Ros-Lehtinen, to the floor; bring the Goodlatte bill, which has been reported out of the Republican Judiciary Committee, to the floor; bring a bill cosponsored by Mr. Hurd and Mr. Aguilar to the floor.

Then what we provide, Mr. Leader, is that the Speaker can bring a bill to the floor of his choosing. What could be fairer than that to let the people's House speak on this critically important issue? So I would hope the gentleman would facilitate that coming to the floor.

Lastly, Mr. Speaker, let me say that this is the most closed Congress in history. He talks about coming to his office, and I have. We have worked constructively and positively together, and I have great respect for the majority leader. I know he is very close to President Trump, and he has talked about his working with President Trump to move forward.

Let us hope that the talks with Korea bear fruit. We have had a lot of talks with the Koreans. They have made a lot of pledges, and they haven't followed them. We will see what happens. We are hoping for the best.

In coming to your office, we have had some discussions. We have had discussions about DACA. But, very frankly, when we come to this floor, this is the most closed Congress, Mr. Leader, in recent history, if not history. We have had 85 closed rules. Zero, not a single open rule have we considered.

Over 2,000 germane amendments have been blocked by the Rules Committee. Mr. Speaker, that is amendments that are in order, and they have been blocked. In fact, 194 Republicans--Republicans--have been refused the opportunity to move forward on their amendments.

Now, I know that the leader's schedule is such that we can conclude this debate. I have other things to say. But I am hopeful that, frankly, whatever we bring to the floor, bring it on a rule that provides for full consideration, bring it that reflects facing the tough issues, bring it so the House can work its will on these bills, including the farm bill, including an immigration bill that protects the Dreamers, and including other legislation so critical to this country. Let the House work its will through the amendatory process.

Mr. Speaker, unless the gentleman wants to say something, I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I may consume, and I thank the gentleman for yielding the customary 30 minutes.

Mr. Speaker, I rise in opposition to the rule that provides for consideration of H.R. 2851, H.R. 5735, and H.R. 5788. We could have done so much better. I am going to get into some of the great ideas that we talked about and amendments were submitted but didn't make it through.

This week is supposed to be about bringing bills to the floor that actually do something about the opioid crisis that is having devastating consequences on families and entire communities, including in my home State of Colorado.

Legislation to address opioid abuse and save lives is long overdue. But I am sad to say that the bills that are being brought forth make, at the most, incremental changes and will not substantially affect the plague that is affecting our country of opioid addiction, abuse, and death.

As you know, this is a crisis that cuts across State lines. It affects every congressional district in our country. I certainly know people directly affected in my constituents. I am sure every Member of Congress does.

In Colorado the rate of drug overdoses since 2000 has more than doubled. This is not a partisan issue, and I

wish we could come together around a more significant response that actually did something to combat opioid abuse.

If Republicans were serious about dealing with opioids, they would drop their assault on Medicaid. Medicaid is a critical service to help individuals battling opioid addiction, including supporting inpatient treatment centers and case managers to help get people the help they need.

Frankly, we should have a discussion about how to achieve universal healthcare. There are people today who are unable to get coverage or support to recover from the substance abuse that holds them hostage. While Medicaid and the Affordable Care Act have dramatically improved and expanded access to health coverage, including drug treatment, there are too many Americans today--in fact, over millions--who do not have health insurance.

There is no single solution to the opioid crisis. Instead, policymakers should use a multipronged approach, universal healthcare, substance abuse, and mental health treatment being one. Another prong is identifying alternative treatments, instead of highly addictive opioid compounds for pain management. That is one of the things that I am so disappointed is not being advanced to the floor.

Many States have medical marijuana available to patients with a variety of health issues, including chronic pain. Doctors across the country have prescribed medical marijuana as a legitimate treatment option for pain management. In cases where it works, it provides a less harmful alternative, a less harmful and less addictive alternative to opioids.

Opioids have a role in pain management. But if a first-line therapy like medical marijuana, acupuncture, or acupressure can work, you can prevent people from developing a dependency, because almost three- quarters of opioid abuse starts with prescription drug treatment for pain management. In some cases, those first-line treatments like medical marijuana, acupuncture, and acupressure won't work, and prescriptions to opioids have their role. But let's at least prevent some people from having to go on prescription opioids when a less harmful, less addictive, and less damaging therapy can work effectively for their pain management. I have heard from so many Coloradans for whom medical marijuana works instead of having to resort to opioids.

Unfortunately, medical marijuana is still illegal at the Federal level. There are limited research opportunities about the safety and efficacy of marijuana, and that is holding us back from really understanding how medical marijuana can be used for pain management.

I offered a very simple and commonsense amendment at the Rules Committee last night that authorizes the Secretary of Veterans Affairs to study medical marijuana as an alternative treatment option to prescription opioids, just very simply. According to the Department of Veterans Affairs, the VA alone has treated about 70,000 veterans for opioid addiction last year alone, but my amendment was, unfortunately, blocked from getting a vote.

The issue is personal for me, Mr. Speaker. I was able to present a Purple Heart to a veteran who lives in my district in Colorado, a young man who put his life on the line for our country. He told me that he uses medical marijuana for his pain issues and has successfully been able to take himself off of the opioids that the VA had prescribed for those pain issues.

I also offered an amendment with Representatives Pocan and Gosar last night that, unfortunately, was not even allowed to be debated here on the floor that would prevent a natural botanic substance like kratom from being scheduled under the new scheduling authority created by SITSA. Unfortunately, it was blocked.

Kratom, which is a cousin of the coffee plant, is used by many as an alternative to addictive opioids and a way of escaping addiction. I have heard from so many constituents for whom legal access to kratom is critical to their sobriety and their battle against opioid addiction.

We can very simply ensure that that legal access could be retained had this amendment been allowed. If it is cut off, as the FDA and others have been threatening, there is no doubt in my mind, nor should there be any doubt in anybody's mind, that people will resort back to deadly opioids, rather than managing through harm reduction using other compounds that are less dangerous and less deadly, be it medical marijuana or kratom.

We are debating these bills today because we know we need to take action to address the opioid epidemic that we all have felt the human face of in our communities. But instead of trying to ban substances and put more Big Government bans on top of things that people are using to recover from opioids, we should be exploring and embracing alternative treatment options to opioids.

Simply put, we need to improve access to alternative pain relief options beyond opioids like kratom and like medical marijuana, because 75 percent of opioid abuse starts with prescription drugs usually for pain management. We need to embrace that part of the solution. Increase freedom. Let Americans choose less harmful compounds that work for pain management and free people up to never become the victim of a terrible cycle of opioid addiction. Unfortunately, both of those amendments were blocked.

H.R. 2851, the Stop the Importation and Trafficking of Synthetic Analogues Act, is a bill that would create a new schedule of drugs under the Controlled Substances Act giving even more authority to the Department of Justice to wage a failed drug war and determine which substances are illegal, sidestepping the current process for scheduling drugs, sidestepping Congress, and often sidestepping common sense. When you put Government bureaucrats in charge, they only take more power every time.

This bill creates lengthy sentencing and penalties, indulging in the over criminalization. It could harm hundreds of thousands of people battling opioid abuse by relying on incarceration and penalization, rather than treatment and helping people recover from opioid abuse.

This is a public health issue. It is not that there is not a criminal dimension; there, of course, is for cartels and smugglers. But when it comes to your niece or nephew, Mr. Speaker, your cousin or your neighbor's kid, we want to help them get better, recover their lives, and free themselves from the vicious cycle of opioid addiction. This bill does not do that.

While it is well-intended, it has serious flaws that need to be addressed. If we want to have an impact on fighting epidemics, the answer is not to give even more authority to government bureaucrats in Washington. It is to empower the American people themselves to take control of our own destiny.

The rule also provides for consideration of the THRIVE Act, that is H.R. 5735. It is a different topic, but it is related. It is designed to create housing opportunities for people suffering from substance abuse disorders.

The problem with this bill is it sets arbitrary time limits on those who seek stable housing while receiving treatment for substance use disorders, and it doesn't actually increase the supply of affordable housing.

When we are dealing with homelessness and transitory housing, we need to take meaningful action to actually increase the supply of beds for people who are in recovery. We have to walk the walk. Without funding for beds and for treatment, we are just talking around the edges and we are not really solving this problem.

The final bill under this rule is H.R. 5788, the Securing the International Mail Against Opioids Act, which is another bill that creates more paperwork for the Postal Service. Frankly, it just adds, again, another level of bureaucracy.

I am pretty sure, Mr. Speaker, that people smuggling opioids into this country don't put opioids on the Customs form. They don't say: ``We are illegally bringing opioids into the country.'' Yes, we need to do more against smuggling, but creating more forms to fill out by government bureaucrats is not the answer.

This bill is being considered under a closed rule. This is the 86th closed rule of this Congress. What that means, Mr. Speaker, is that not a single Member, Democrat or Republican, was able to

offer an amendment to this bill, the Securing the International Mail Against Opioids Act. There were good ideas from both sides that aren't even allowed to be advanced.

The Republicans continue to bring bills to floor this way that limit the opportunity for Republicans and Democrats to actually do something to stop opioid abuse. It is frustrating.

As a legislator who has a lot of ideas about what we can do to actually save lives, increase freedom, and reduce opioid abuse, which would pass--I think a lot of my ideas would get 300, 350 votes here in the House--we are not even allowed to bring them forward. It is just so frustrating when we all know the human face of people who are suffering from being caught in the vicious cycle of opioid addiction. We have seen it affect so many families, including so many of our friends and even family.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, our Nation is in the midst of a devastating opioid crisis that is spiraling out of control. According to the Centers for Disease Control and Prevention, opioids are responsible for 6 out of 10 overdose deaths in the country. More than 115 Americans die each day from opioid overdose.

The house is on fire; yet, with these bills today, unfortunately, the Republicans are not addressing this problem in a meaningful way. The American people need strong action from Congress to stem the tide of the opioid scourge and save lives.

Mr. Speaker, if we defeat the previous question, I will offer an amendment to the rule to bring up Representative Lujan's legislation, H.R. 3495, the Opioid and Heroin Abuse Crisis Investment Act, which would make a difference by extending badly needed funding to combat the growing public health crisis of opioid-related addiction and deaths.

Mr. Speaker, I ask unanimous consent to insert the text of my amendment in the Record, along with extraneous material, immediately prior to the vote on the previous question.

Mr. Speaker, I yield 3 minutes to the distinguished gentleman from New Mexico (Mr. Ben Ray Lujan) to discuss our proposal.

Mr. Speaker, I yield the gentleman an additional 30 seconds.

Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from Texas (Mr. Doggett), the distinguished ranking member of the Ways and Means Subcommittee on Tax Policy.

Mr. Speaker, I yield an additional 1\1/2\ minutes to the gentleman from Texas.

Mr. Speaker, I yield 4 minutes to the gentleman from Maryland (Mr. Cummings), the distinguished ranking member of the Committee on Oversight and Government Reform.

Mr. Speaker, I yield an additional 30 seconds to the gentleman from Maryland.

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, here we are, a year and a half into this session of Congress, and finally the Republicans are bringing something to the floor around the opioid epidemic, but it is too little, too late. They prioritized, unfortunately, corporate tax giveaways over families that are struggling and communities which are affected by the path of destruction caused by opioid drug abuse.

As we address opioid addiction, we need to remember that many communities were suffering from substance use disorders long before Congress began to wake up to this issue. Opioid abuse affects both rural and urban communities and has a human face and a tragedy in every congressional district.

We should support efforts to address this through treatment instead of incarceration or punishment, through alternatives instead of giving Washington, D.C., bureaucrats more power.

Mr. Speaker, I urge my colleagues to vote ``no'' on the previous question and ``no'' on the rule, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I demand a recorded vote.